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ENDOCRINOLOGY*

*See also the Lawson Wilkins Pediatric Endocrine Society Program

8:45am-9:45am
LWPES Plenary Session
4010A LWPES Plenary Session I
Genentech Clinical Scholar: The Role of IGFBP3 in Mediating p53-Induced Cell Apoptosis
Adda Grimberg, Pediatric Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA
Lawson Wilkins Lecture: Endocrine Effects of Childhood Cancer
Stephen M. Shalet,

9:15am-12:00pm
Mini Course
4010 Long-Term Effects of Childhood Cancer
Chair: Smita Bhatia, City of Hope National Medical Center, Duarte, CA
This mini-course will address several of the major topics of interest relating to the long-term health status and psychosocial functioning of individuals diagnosed and treated for cancer during childhood and adolescence. Topics to be presented include endocrinologic sequelae, risk of subsequent malignancies, psychosocial late-effects, and educational/intervention strategies.

9:15am-12:00pm
Mini Course
4011 Stem Cell Transplantation
Chair: Nancy Bunin, Children's Hospital of Philadelphia, Philadelphia, PA
This mini course will provide participants with an update on both the current status and future of stem cell transplant in pediatrics. Both malignant and non-malignant diseases will be addressed. Advances in graft engineering have made many of these advances possible, and this will be discussed in an overview of autologous stem cell transplant for solid tumors. Allogeneic stem cell transplant may be curative for some patients with hemoglobinopathies and metabolic diseases. Non-myeloablative approaches to hemoglobinopathies are a relatively novel approach, which may be curative without some of the short and long-term toxicities of a myeloablative regimen. Disease-specific characteristics that impact upon transplant outcome of patients with inherited metabolic storage disorders will be identified and discussed. Finally, the concepts of mesenchymal cell transplant and the future of mesenchymal cell transplant therapy will be summarized and discussed.

12:00pm-3:00pm
Mini Course
4103 Sports Participation by Chronically Ill Children and Adolescents: Let the Games Begin!
Chair: Dilip Patel, Michigan State University, Kalamazoo Center for Medical Studies, Kalamazoo, MI

1:00pm-3:00pm
LWPES Symposium
4160A LWPES Esoterix Lecture/Genetics Symposium
Genetic Testing in Endocrinology: Ethical Considerations
Norman Fost
Overview of Human Genetics/Genomics: Relevance to Pediatric Endocrinology
Barton Childs
Single Gene Defects and What They Have Taught Us About Developmental and Clinical Endocrinology
Keith Parker

3:15pm-5:15pm
Topic Symposium
4200 Cloning and Embryonic Stem Cells
Chair: Judith Hall, University of British Columbia, Vancouver, Canada
There is enormous public interest in cloning and embryonic stem cells. This symposium will update the pediatric community on recent developments and raises a variety of policy and ethical issues.

3:15pm-5:15pm
Platform Session
4255 LWPES Fellow Awards and Molecular Studies: Endocrinology I
Chairs: Patricia A. Donohoue and Joseph A. Majzoub

5:15pm-7:15pm
Poster Session I (Author Attended)
and Opening Reception
– Endocrinology
– Neonatology

7:15pm-9:30pm
Alliance Club
4500A Perinatal Nutrition and Metabolism Club
Long-Term Developmental Consequences of Perinatal Malnutrition
Janina Galler, Boston University School of Medicine, Boston, MA

8:00am-11:00am
Mini Course
5090 Adolescent Medicine - Part II—Eating Disorders
Chair: Donald E. Greydanus, Michigan State University, Kalamazoo, MI
This presentation will present an overview of the research on the diagnosis, assessment, and treatment (therapy: including psychological and pharmacological; settings: inpatient, day treatment, and outpatient) of adolescents with eating disorders. A brief comparison of the diagnostic criteria used by the American Psychiatric Association and the World Health Organization will be presented and discussed regarding the relevance to research design and diagnosis. Special issues (such as research design, subject selection, research settings, geographical location, definitions, terminology, race and culture, managed care, and reimbursement) and their impact on our current knowledge base and on treatment choices will be addressed. Recommendations for future directions in assessment, treatment, and research will be offered.

11:45am-1:45pm
Poster Session II
– Endocrinology

1:45pm-2:30pm
State of the Art Plenary
5590 Children as Victims of Bioterrorism: Protecting the Fragile Host
Chairs: Phyllis Dennery, Stanford University School of Medicine, Palo Alto, CA and Tina Lee Cheng, Johns Hopkins University School of Medicine, Baltimore, MD
With the recent world events and new threats of biowarfare, what should pediatricians know? Due to their size and physiology, children are at higher risk of injury from bioterrorism. This session will address the biology, clinical manifestations, and possible preventive strategies for likely biowarfare agents. The unique vulnerability of the child will be addressed.

2:00pm-4:00pm
State of the Art Plenary
5701 Children as Research Subjects: Ethical and Regulatory Issues
Chair: Myron Genel, Yale University School of Medicine, New Haven, CT
A number of highly publicized adverse events, including the death of two volunteers participating in non-therapeutic research, and the federal shutdown of research at many well-recognized academic institutions because of inadequate compliance with regulatory requirements have intensified scrutiny of the protection afforded to human subjects participating in research, including children. Furthermore a Maryland court has recently decreed that children cannot participate in research without the potential for direct benefit. As a consequence there has been increasing media attention and Congressional concern regarding the adequacy of institutional oversight and investigator attentiveness to established standards and regulations. In addition, new regulations issued under the Health Insurance Portability and Accountability Act of l996(HIPAA) threaten the capacity to conduct health services and outcomes research. These issues will be addressed in the 9th annual Public Policy Plenary Symposium in an interactive format intended to stimulate dialogue among the members of the panel and with the audience.

2:30pm-4:00pm
State of the Art Plenary
5703 Insulin Resistance Syndromes
Chairs: Alan Rogol, Insmed Pharmaceuticals, Inc., Glen Allen, VA and Charlotte Boney, Rhode Island Hospital, Providence, RI
Insulin resistance is the underlying factor in many of the consequences of obesity in childhood and adolescence, including ovarian hyperandrogenism, hypertension, hyperlipidemia, and Type 2 diabetes. Obesity, dyslipidemia, and Type 2 diabetes are components of SyndromeX in adults, a serious public health issue. In addition, insulin has a role in the regulation of leptin, the major signal of adiposity to the brain. Dr. Arslanian will discuss insulin resistance in polycystic ovary disease and Type 2 diabetes. Dr. Freedman will review the cardiac risk factors related to insulin resistance, and Dr. Roemmich will discuss the insulin-leptin axis in obesity and puberty.

4:15pm-6:00pm
Platform Session
5903 Clinical Investigation: Endocrinology II
Chairs: Bruce A. Boston and Ali S. Calikoglu

4:15pm-6:15pm
Topic Symposium
5801 IUGR—Recent Advances
Chair: David Carlton, University of Wisconsin, Madison, WI 
Intra-uterine growth restriction leads to various adaptive changes in blood flow and metabolism which leads to fetal survival in an adverse environment. This session will address these adaptive changes which occur in-utero and the long-term impact secondary to these changes in the adult IUGR progeny. Dr. Battaglia will present information related to blood flow and hepatic metabolism in the human fetus/infant, Dr. Devaskar and Dr. Hill will present work in animal models that sets the IUGR fetus towards developing diabetes as an adult. Dr. Devaskar will present changes in various organs, while Dr. Hill will focus on changes that occur in the beta-islets of the pancreas.

4:15pm-6:15pm
Platform Session
5911 Pediatric Nutrition and Metabolism
Chair: Michael R. Narkewicz

8:00am-10:00am
Topic Symposium
6000 Human Brain Imaging: Insights into Development and Plasticity
Chairs: Sherin U. Devaskar, University of California, Los Angeles, CA and Joseph J. Volpe, Boston Children's Hospital, Harvard Medical School, Boston, MA
State-of-the-art imaging of the human brain has been achieved by advances in magnetic resonance imaging (MRI) and positron emission tomography (PET). Recent work with MRI and PET has provided remarkable insights into the structure and the function of the brain of infants and children during normal development and with plasticity. In this session, reviews of the insights obtained with such techniques as 3D-volumetric and diffusion tensor MRI, functional MRI, and PET-based studies of brain receptors and metabolism will be presented by leaders in the field. Emphasis will be on the most recent findings, including considerable unpublished work.

8:00am-10:00am
Poster Symposium
6050 Advances in Clinical Nutrition
Chairs: Michael R. Narkewicz and David K. Rassin

8:00am-10:00am
Platform Session
6053 Diabetes and Endocrinology
Chairs: Michael S. Freemark and Antoinette M. Moran

10:30am-12:30pm
LWPES Plenary Session
6250A LWPES Plenary Session III - Mini Symposium
Breaking the Obesity–Type 2 Diabetes Link
Opening Remarks
Desmond A. Schatz, University of Florida, Gainesville, FL

12:30pm-2:30pm
Award
6400 March of Dimes Prize in Developmental Biology Lectures
Presented by the March of Dimes Birth Defects Foundation

2:45pm-4:45pm
Topic Symposium
6501 Gene Nutrient Interaction
Chairs: Sherin Devaskar, Mattel Children's Hospital, University of California, Los Angeles, CA and William Hay, Jr., University of Colorado School of Medicine, Denver, CO
Recent exciting advances in defining the human genome have provided new opportunities in research for understanding the regulation of gene expression. One important focus of this area of science is the role of the metabolic milieu on gene expression and function during critical periods of development. This session will address the effect of nutrients and metabolic conditions on three aspects of metabolic gene regulation. William Heird will discuss how essential fatty acids regulate the expression and activity of genes and gene products that in turn are essential for regulation of fatty acid metabolism. These processes are fundamental during fetal and neonatal life when essential fatty acids are particularly important for structural development of the central nervous system and for the provision of key intermediary substrates that coordinate the development and activity of such diverse functions as vascular tone, inflammation, and nutrient metabolism. Christopher Newgard will discuss how aspects of the metabolic milieu affect pancreatic beta cell development and function, and then will explore molecular engineering approaches to modifying pancreatic beta cell/islet gene expression of genes that regulate insulin production and secretion. Barbara Kahn will discuss the molecular mechanisms involved in causing substrate-induced insulin resistance, reflecting on conditional gene knockout models of insulin resistance in adipose tissue and skeletal muscle. Together these talks will provide valuable information about mechanisms responsible for the effect of nutrients and nutrient metabolic products on key regulatory genes involved in growth and metabolism, leading to increased insight into exciting research opportunities in potential therapeutic manipulations of gene activity.

10:00am-11:45am
State of the Art Plenary
7202 Pharmacogenomics: Clinical and Therapeutic Implications
Chairs: James Padbury, Women & Infant's Hospital of Rhode Island, Brown University, Providence, RI
The availability of high density sequence databases for large segments of the human genome has lead to the identification of single nucleotide polymorphisms (SNPs) in many important genes. If these SNPs occur in regulatory regions of important catalytic proteins, occur in binding domains of transmembrane signaling molecules or occur in the regulatory region of a gene, they can profoundly affect the function of that gene and on an individual patient basis. It has become clear these mechanisms account for some of the highly variable, once considered "idiosyncratic", responses to drug therapy. Pharmacogenomics is the study of how genetics affects responses to drugs. Pharmacogenomics holds the promise that drugs might one day be tailor-made for and adapted to each person's own genetic makeup. In this symposium speakers will present prominent examples of how pharmacogenomic implications affect the biology of disease and therapy from the fields of behavioral genetics and sychotherapeutics, cancer chemotherapy and the treatment of asthma. The perspectives presented will help the attendee understand a pathobiological and clinically sound approach to these disorders. The discussion will include basic science, clinical research and an industry perspective on this rapidly emerging area of importance.

1:45pm-3:45pm
Hot Topic
7702 Disaster Preparedness: Beyond 9/11
Chairs: Tina L. Cheng, Johns Hopkins University School of Medicine, Baltimore, MD; Danelle Laraque, Mount Sinai School of Medicine, New York, NY; and Benard Dreyer, New York, NY
The impact of 9/11 and the public health aftermath have affected us personally and professionally. This session will address what the child health professional needs to know regarding disaster planning and preparedness. Speakers will review and provide updates on national and regional systems for emergency management and how those systems interact with local public health agencies, the pediatrician's role in the community's preparedness including what the school system, the pediatric office and the patient should be doing to prepare and respond, recognition and management of chemical and biologic agents of terrorism, and the psychological reactions to disaster and stress.